Canadian Pandemic Influenza Preparedness: Communications Strategy

"When faced with uncertainty and unpredictability, early and transparent communication during a pandemic is critical to build trust and to ensure the credibility of public health advice."

This article summarises the communication strategy outlined in the Communication and Stakeholder Liaison Annex of the Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP). The Annex was updated following the 2009 H1N1 pandemic, which underscored the importance of clear, frequent, and coordinated outreach to the public and key stakeholders, as well as the need to plan for pandemics of varying impact.

As is explained here, in a pandemic, risk communication objectives are to inform and to engage Canadians and the organisations that represent them about the risks posed by the pandemic so that people can take appropriate actions - e.g., get a flu vaccine. Because Canadians are a diverse population, this is done by conveying the relevant information in formats that are accessible and tailored to audience needs (e.g., in different languages, culturally sensitive), using multiple platforms (e.g., delivery by local leaders such as community elders or town mayors), and coordinating communications through a clear focal point (i.e., the Public Health Agency of Canada, or PHAC). Established federal, provincial, and territorial (FPT) networks are accessed to ensure consistency in messaging, share best practices, and adjust approaches as necessary during the pandemic.

To that end, the updated Annex "uses a flexible and scalable approach to planning and includes best practices in risk communications. It integrates a broad range of communication methods such as social marketing, social media and stakeholder consultation. It outlines the roles and responsibilities of FPT governments in communications during a pandemic and the mechanisms through which key messages are coordinated, such as through established networks and nongovernmental organizations."

A specific approach to the strategy involves aligning communication strategies with trends in how Canadians access and use health information. "Planners need to accommodate the fact that some Canadians have no or limited or unreliable Internet access. In addition, some populations may benefit from receiving information in different formats and languages, for example, those with hearing or visual impairments or low literacy, recent immigrants, or people experiencing homelessness. Several strategies can be used to reach Canadians: direct outreach to communities, traditional media (e.g., newspapers, telephone, radio and television), and new media trends and creative approaches (e.g., engaging outreach workers, social media) in addition to online media outlets."

Six guiding principles for communications during an influenza pandemic are outlined in the Annex. They reflect the CPIP's guiding principles of ethics, collaboration, proportionality, and evidence-informed decision-making. Also central is the need to monitor public risk perception, which is an indicator of willingness to change behaviour (e.g., vaccination, hand hygiene) during a public health event. The Annex emphasises that public health authorities and trusted sources (e.g., nurses, doctors, pharmacists, community leaders, elders) not only influence early behaviours, but also establish the presence of a source of expert guidance and advice to help Canadians better understand the risks. However, social media plays an increasingly important role in how the public perceives risk; CPIP stresses that strategies must be in place to counter misinformation ("fake news"). Stakeholders should also anticipate media and public questions and concerns on vaccine issues, for example, in one of the various scenarios detailed in a chart within the paper (the scenario of an influenza virus with high transmissibility and low virulence).

CPIP points to the importance of systematic evaluation of the overall communications response: continuously, between the first and second waves, and after the pandemic. To assist in these efforts, the Annex includes a list of performance indicators for both communication processes and outcomes. In addition, there is an ongoing need to consider new communications tools, techniques and methodologies.

In conclusion: "The urgent and unpredictable nature of pandemics require a systematic approach to risk communications. In the early stages, evidence about the impact of a pandemic and the populations most at risk may be limited. The Communications and Stakeholder Liaison Annex has been designed to provide scalable communication strategies for varying pandemic wave activities in ways that will increase trust and self-empowerment among Canadians."